Effects of intentional weight loss in patients with obesity and heart failure: a systematic review

McDowell, K., Petrie, M. C. , Raihan, N. A. and Logue, J. (2018) Effects of intentional weight loss in patients with obesity and heart failure: a systematic review. Obesity Reviews, 19(9), pp. 1189-1204. (doi: 10.1111/obr.12707) (PMID:30051959)

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Abstract

Objective: Obesity is an independent risk factor for the development of heart failure, and the two commonly co‐exist. The European Society of Cardiology does not provide guidance regarding weight loss strategies in heart failure. The aim of this study was to systematically review the evidence for outcomes following intentional weight loss in patients with heart failure and obesity. Method: A systematic review of English articles was undertaken using databases PubMed, Embase and CENTRAL. Randomized controlled trials and observational studies reporting outcomes following intentional weight loss by lifestyle, surgical or pharmacotherapy intervention in patients with obesity and heart failure were included. Results: Four randomized controlled trials and seven observational studies were identified. Two randomized controlled trials used diet and exercise as an intervention, one used diet alone and one used a pharmacological intervention (orlistat). All but one reported significant weight loss. Two reported improvement in exercise capacity and quality of life. One reported improvement in New York Heart Association functional class in heart failure with preserved ejection fraction. The observational studies, five of which reported on outcomes following bariatric surgery, despite being small, heterogeneous and high risk of bias, suggested a trend in improvement of left ventricular function, quality of life and exercise capacity following weight loss. Conclusion: Weight loss is achievable with lifestyle intervention in those with heart failure and obesity and may result in improvements in New York Heart Association classification, quality of life and exercise capacity.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Petrie, Professor Mark and Logue, Dr Jennifer
Authors: McDowell, K., Petrie, M. C., Raihan, N. A., and Logue, J.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Obesity Reviews
Publisher:Wiley
ISSN:1467-7881
ISSN (Online):1467-789X
Published Online:27 July 2018
Copyright Holders:Copyright © 2018 World Obesity Federation
First Published:First published in Obesity Reviews 19(9): 1189-1204
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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